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自闭症患者心血管自主调节和生长因子的变化。

Alternations in the Cardiovascular Autonomic Regulation and Growth Factors in Autism.

机构信息

Biomedical Center Martin JFM CU, Mala Hora, Martin, Slovak Republic

出版信息

Physiol Res. 2021 Aug 31;70(4):551-561. doi: 10.33549/physiolres.934662. Epub 2021 Jun 1.

Abstract

Autism spectrum disorder (ASD) represents a serious neurodevelopmental disorder associated with autonomic nervous system dysregulation. The aim was to study complex cardiovascular autonomic regulation using heart rate variability (HRV) and systolic blood pressure variability (SBPV) linear/non-linear analysis at rest and during orthostasis, and to assess plasma levels of epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) in autistic children. Twenty-five ASD boys and 25 age and gender-matched children at the age 7-15 years were examined. After venous blood taking, continuous ECG and blood pressure biosignals were recorded at rest and during orthostasis. Evaluated parameters: RR intervals, high- and low-frequency band of HRV spectral analysis (HF-HRV, LF-HRV), symbolic dynamics parameters 0V%, 1V%, 2LV%, 2UV%, low- and high-frequency band of SBPV (LF-SBPV, HF-SBPV), systolic, diastolic, mean blood pressure, EGF, VEGF plasma levels. RR intervals were significantly shortened and the HF-HRV, LF-SBPV, HF-SBPV parameters were significantly lower at rest, the HF-HRV and LF-SBPV remained lower during orthostasis in autistic children compared to controls (p<0.05). EGF plasma levels were significantly lower in ASD compared to controls (p=0.046). No significant differences were found in remaining parameters. Our study revealed tachycardia, cardiovagal underactivity, and blunted sympathetic vasomotor regulation at rest and during orthostasis in autistic children. Additionally, complex heart rate dynamics are similar in autistic children than controls. Furthermore, EGF was reduced in autistic children without significant correlations with any autonomic parameters. We suggest that the abnormal complex cardiovascular reflex control could contribute to understanding the pathway linking autonomic features and autism.

摘要

自闭症谱系障碍(ASD)是一种严重的神经发育障碍,与自主神经系统失调有关。本研究旨在使用心率变异性(HRV)和收缩压变异性(SBPV)线性/非线性分析,在静息和直立位期间研究复杂的心血管自主调节,并评估自闭症儿童的表皮生长因子(EGF)和血管内皮生长因子(VEGF)的血浆水平。我们检查了 25 名 ASD 男孩和 25 名年龄和性别匹配的 7-15 岁儿童。在静脉采血后,在静息和直立位期间记录连续心电图和血压生物信号。评估的参数包括:RR 间期、HRV 频谱分析的高频和低频带(HF-HRV、LF-HRV)、符号动力学参数 0V%、1V%、2LV%、2UV%、SBPV 的低频和高频带(LF-SBPV、HF-SBPV)、收缩压、舒张压、平均血压、EGF、VEGF 血浆水平。与对照组相比,自闭症儿童在静息时 RR 间期明显缩短,HF-HRV、LF-SBPV、HF-SBPV 等参数明显降低,HF-HRV 和 LF-SBPV 在直立位期间仍然较低(p<0.05)。与对照组相比,自闭症儿童的 EGF 血浆水平明显降低(p=0.046)。其余参数无显著差异。我们的研究表明,自闭症儿童在静息和直立位时存在心动过速、迷走神经活动不足和交感血管运动调节迟钝。此外,自闭症儿童的心率动力学与对照组相似。此外,自闭症儿童的 EGF 减少,但与任何自主参数均无显著相关性。我们认为,异常的复杂心血管反射控制可能有助于理解将自主特征与自闭症联系起来的途径。

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